Endometriosis – A Chameleon: Patientsʼ Perception of Clinical Symptoms, Treatment Strategies and Their Impact on Symptoms

Abstract

Introduction: Endometriosis is a chronic disease with differing clinical presentations. Treatment strategies depend mainly on clinical presentation and patient lifestyle. In women newly diagnosed with endometriosis, it is often difficult to understand the pathophysiologic origin, the potential individual impairment due to disease and the different treatment options. Compliance with the selected treatment is therefore often not optimal. Material and Methods: In a descriptive study, data of 51 women with endometriosis (mean age 36.2 years ± 11.3) were analyzed according to the predominant clinical presentation: asymptomatic disease, disease with typical symptoms, ovarian cysts or infertility. Results: More than 50% of patients ascribed a therapeutic benefit to surgical intervention or endocrine treatment, especially women in the subgroup with dysmenorrhea who received combined treatment. It should be noted that in the group of women facing infertility, more than half stated that they could not decide on the value of diagnostic and therapeutic reproductive medicine. Nevertheless, more than half of the women in this group became pregnant within two years after the initial diagnosis. Discussion: When deciding on the best treatment strategy for endometriosis, it is important to take account of potential pain and infertility. Womenʼs perception of endometriosis will vary depending on their symptoms, the time of diagnosis and their lifestyle. Offering continuous information on clinical aspects and manifestations of the disease may improve treatment outcomes. Personalized counseling is an essential part of the clinical management of the disease.

Differences in the Time Course of Disease Progression, Quality of Life and Health Service Utilization in Women with Endometriosis

“…The high disease burden in endometriosis patients with an early onset of symptoms was reflected in poor pain scale and health status scores, thus confirming the results of the multicenter study by the World Endometriosis Research Foundation (15). Furthermore, the possibility that women with a longer delay in diagnosis might have problems comprehending the wide range of available diagnostic and therapeutic options and understanding the consequences of non-compliance or non-optimal compliance cannot be excluded (16).…”

Strong Association Between Endometriosis and Symptomatic Leiomyomas

“…Based on these preliminary findings, we believe that in a subset of patients with symptomatic fibroid tumors and pelvic pain, endometriosis must be seriously considered as a concomitant diagnosis and may be more common than previously thought. Because of the multifaceted nature of this disease, endometriosis is often called the great masquerader 37 or the chameleon of the pelvis, 38 as lesions are easily overlooked. It is especially possible to miss it by laparotomy, because one may not be able to completely visualize the posterior cul-de-sac, ovarian fossa, and broad ligaments in great detail.…”

Diagnostic Benefit of the Detection of Mitotic Figures in Endometriotic Lesions

“…A prospective multicenter study evaluating longitudinal clinical data in combination with repeated standardized pain questionnaires might find statistical differences. Women with symptoms of infertility have higher stages of endometriosis after an invasive diagnosis 20 , 24 .…”